Importance of ventricular function in the election of electro heart mode

Med Intensiva. 2015 Apr;39(3):172-8. doi: 10.1016/j.medin.2014.09.002. Epub 2014 Dec 30.
[Article in English, Spanish]

Abstract

The integration of the ventricular function is essential when making decisions over a patient subjected to cardiac electrostimulation in order to understand the structure followed in the new cardiac stimulation and resynchronising therapy guides. To support the importance of ventricular function in cardiac electrostimulation it is important to know: (i)the deleterious effect of stimulation on the right ventricle apex; (ii)the effect over the left ventricular function produced by complete blockage of the left branch, and (iii)left ventricular disfunction as arrythmogenic substrate. When it comes to decide what type of cardiac electrostimualtion to apply we will know: the percentage of ventricular stimulation needed and its ventricular function. A normal ventricular function will enable electrostimulation from the right ventricle apex or alternative site. On the contrary, if this value is lower than 50% the most recommended electrostimulation is cardiac resynchronisation (CRT-P), which will be accompanied by defibrillation (CRT-D) if FEVI is lower than 35%.

Keywords: Biventricular pacing; Cardiac electrostimulation; Cardioverter-defibrillation; Desfibriladores; Electroestimulación cardiaca; Función ventricular; Marcapasos; Pacemakers; Resincronización cardiaca; Ventricular function.

Publication types

  • Review

MeSH terms

  • Cardiac Pacing, Artificial / methods*
  • Cardiac Resynchronization Therapy / methods
  • Clinical Decision-Making
  • Clinical Trials as Topic
  • Death, Sudden, Cardiac
  • Electric Countershock / methods*
  • Electrophysiologic Techniques, Cardiac / methods*
  • Heart Rate
  • Heart Ventricles / physiopathology*
  • Humans
  • Stroke Volume
  • Systole
  • Ventricular Dysfunction, Left / physiopathology